OVER-THE-COUNTER PSYCHOTROPICS - A REVIEW OF MELATONIN, ST JOHNS WORT, VALERIAN, AND KAVA-KAVA

Use and availability of alternative healthcare products have revived i n the last few years. The prevalence of supplement use in the United S tates is largely unknown but is thought to be widespread. In this arti cle, four of the common substances used to treat emotional problems ar e reviewed. The plant or substance description, clinical indications, evidence of therapeutic efficacy, mechanisms of therapeutic actions, d osages and regimens, different commercially available preparations, an d adverse effects and toxicities are described for melatonin, St John' s wort, valerian, and kava-kava. That a product is ''natural'' does no t mean that it is either safe or effective. Many supplements are poten t drugs that lack sufficient data on safety, dose-response relationshi ps, drug interactions, and purity.